The comparison effect of intrathecal hyperbaric bupivacaine, ropivacaine and levobupivacaine for cesarean section [Sezaryen operasyonlarinda intratekal uygulanan hiperbarik bupivakain, ropivakain ve levobupivakainin etkilerinin karşilaştirilmasi]

Abstract

Objective: The aim of this study was to compare the effects of intrathecal hyperbaric bupivacaine, ropivacaine and levobupivacaine on the hemodynamic parameters, spinal blockade characteristics, Apgar scores and umbilical veneous blood gases changes in mother and newborn undergoing elective cesarean section. Methods: After the approval of the Ethical Committee and the patients, sixty patients of ASA physical status I-II, undergoing elective cesarean section under spinal anesthesia, were enrolled in this clinical study. Patients were randomized into three groups. Bupivacaine group (n = 20) receiving 8 mg hyperbaric bupivacaine and ropivacaine group (n = 20) receiving 12 mg hyperbaric ropivacaine and levobupivacaine group (n = 20) receiving 8 mg hyperbaric levobupivacaine. Hemodynamic parameters, sensorial and motor blockade characteristics, Apgar scores, umbilical venous blood gas values, postoperative VAS scores, and side effects were recorded. Results: The demographic data, sensorial blockade and duration of surgery of the study groups were comparable (p > 0.05). Also there was no significant difference among the groups with regard to the hemodynamic parameters but in all groups systolic, diastolic and mean arterial blood pressures were decreased when compared with basal values (p<0.05). When Bromage score values were compared between groups in bupivacaine group (%95) values were higher than ropivacaine (%45) and levobupivacaine groups (%75) (p<0.05). The duration of the motor blockade was longer in bupivacaine group than the levobupivacaine and ropivacaine groups (p<0.05). There were no differences among groups with regard to the newborn Apgar scores and umbilical venous blood values (p>0.05). Conclusion: Intrathecally applied equally dosage hyperbaric ropivacaine and levobupivacaine in cesarean sections, could be used successfully without changing the hemodynamic parameters of mothers and newborns. Based on these data, spinal anesthesia with administration of hyperbaric levobupivacaine and ropivacaine can be applied as an alternative to bupivacaine for similar anesthesia conditions, shorter motor blockade duration and earlier patient mobilization times.